The objective of the Cedars-Sinai SCOR Program is to develop innovative solutions to the problems of human coronary artery disease. Thus, although animal investigations traditionally have formed a substantial segment of our overall program, they are dominately oriented toward providing directly relevant clinical applications. Major emphasis, therefore, has been placed upon the development and application of new technology and methods including balloon flotation catheter systems, analog and digital techniques for automated arrhythmia detection using intra-cavitary electrodes, thermodilution methods for measuring regional blood flow, radionuclide techniques for assessing regional perfusion and global function, sonomicrometry, and phased array echocardiographic sector scanning. The most significant emphasis of our program has been upon development of new fundamental knowledge and new technology in these areas. This new technology is being applied clinically in studies designed to quantitate the effect of angiographically documented human stenoses upon both flow and regional function, and the effect of pharmacologic agents upon regional flow, function and metabolism. Results of these investigations are being applied to non-invasive detection of ischemic heart disease and to its therapy. Finally, the follow-up section of this proposal provides on-going long-term evaluation of approximately 1,000 patients treated medically or surgically, based upon documented levels of cardiac function at the time of admission to the Cedars-Sinai Medical Center.